Brace Yourselves: Winter Flu Is Coming!

2013 is shaping up to be another bumper year for colds, flus and noroviruses with medical officials predicting a similar or greater outbreak level to 2012. Here's what you need to know about the impending sniffle season.

This week, health experts gave a snapshot of what's coming this flu season during an Australian Science Media Centre briefing. In the coming months, Australia is expected to be hit by a new strain of norovirus dubbed Sydney2012, an even spread of influenza types and a heady dose of the common cold. Here's an overview of what we can expect...

Rhinovirus (Common cold)

John Upham, Professor of Respiratory Medicine at the School of Medicine, warned that the many strains of human rhinovirus would lead to plenty of cases of the common cold in the coming months.

"There are at least 100 varieties [of rhinovirus] in the community, which explains why it's very common for people to get repeated rhinovirus infections because even though they may become immune to one strain of the virus when a new strain of the virus comes along they no longer have any protection."

Rhinoviruses often peak just after school holidays and are also exacerbated by drops in temperature, Upham said.

"We have known for a long time that you're more likely to get a cold during colder months, particularly in winter. That's because people tend to congregate close together in winter and the virus itself also thrives when the temperatures are a little bit lower. A recent study also suggests that our immune system doesn't function quite as efficiently as it should at low temperatures."

While rhinoviruses can make people feel miserable and unhappy, they usually only cause serious illness when the sufferer has an underlying lung disease, such as asthma.

"Asthma [sufferers] get roughly the number of cold as everyone elses, the consequences are often worse due to abnormalities in the immune system," Upham said.

Interestingly, women under the age of fifty tend to have stronger immunity against rhinoviruses than men due to hormone differences.

Influenza (Flu)

According to Dr Ian Barr, deputy director of the Australian WHO Collaborating Centre for Reference and Research on Influenza, this year's flu season will be difficult to predict, although we can expect it to peak between the months of June and September.

So far, there have been 3379 confirmed cases of influenza in Australia this year, which is slightly up from the same time last year, which was the second highest on record.

Unlike last year's influenza outbreak which was dominated by the A(H3N2) virus, 2013 will involve a more even spread of the four main influenza types, Dr Barr said. Around 50% of cases so far have been of the A(H1N1) variety, with A(H3N2) and the two B Viruses contributing 27% and 22%, respectively.

Unlike rhinoviruses (AKA the common cold), influenza can cause a range of severe illnesses including pneumonia and death. Last year there were 60 recorded fatalities attributed to influenza in Australia, which Barr believes is probably an underestimation. Most of the fatalities were among the elderly, although 23 children were also admitted into intensive care.

Norovirus (Gastro bug)

Last year's gastro virus outbreak is expected to make a fierce comeback this winter according to molecular biologist Professor Peter White. The gastro bug is one of the nastiest of the common viruses, capable of causing nausea, vomiting and diarrhoea. It can be caused by fecally contaminated food or water, person-to-person contact and contamination surfaces.

Last year, a research team led by Professor White identified a new strain of pandemic norovirus dubbed ‘Sydney 2012’. It has since gone on become the predominant norovirus and is responsible for a global pandemic. Around 80 percent of all norovirus infections are now caused by Sydney 2012.

White warned that if the outbreak is severe, the virus could potentially cause emergency department closures with hospital wards forced to turn away new admissions.

"In US and Europe they've already had a severe season, so we might expect a lot more norovirus activity in Australia during August and September of this year...We could have up to 200 institutional outbreaks per month."

2013 Flu Vaccine

This year's flu vaccine contains two new components to better match what's circulating: the A/Victoria-like virus, which was widespread in Australia and the US last year and B/Wisconsin/1/2010.

Barr said there was still plenty of time to get vaccinated in time for the flu season, although you'd be better off acting sooner rather than later: the vaccine usually takes around two weeks to reach its peak. "If you have a vaccination in the next few weeks you should be fine," Barr said.

Additional safety tips

To lessen your chances of catching a cold or virus this winter, wash your hands rigorously multiple times a day and try to avoid touching your mouth, nose or eyes after your hands have come into contact with a shared surface, such as a kitchen bench. Keeping your immune system strong can also assist in a speedy recovery.

If you'd prefer not to be vaccinated, you can get a prescription for anti-viral medicines from your doctor such as Tamiflu.

Natural remedies like vitamin C and echinacea, meanwhile, were classed by Upham as "disappointing". It's also important to try and contain a virus once you have it, especially from people with weak immune systems.

"Once you've got it, it's important to stop other people getting it. Don't go visit granny in the hospital, try to avoid closed-in spaces and just do everything you can to keep it away from the rest of your family," White said.

1. While rhinoviruses tend not to cause significant illness they can even in healthy people. It's usually not the actual virus itself but rather a secondary bacterial pneumonia resulting from a weakened/distracted immune system.
2. True, influenza can cause a serious, fatal even, case of pneumonia. But, like colds, most infections tend to be relatively mild and self-limiting. In fact, the majority of carriers are asymptomatic.

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